Dear Readers,
Today's edition of Paleo Diet Q & A on rheumatoid arthritis.
Q: The article, "Modulation of immune function by dietary lectins in rheumatoid arthritis" is of interest to me, but is 10 years old. Can you suggest any more recent scientifically valid articles on the same topic?
Many thanks,
Allena
A: Hi Allena,
To my knowledge, there are no reviews or studies addressing the role of a paleolithic diet and it's implications in rheumatoid arthritis, except from that of Dr. Cordain. In his MS (Multiple Sclerosis) DVD Dr. Cordain thoroughly explains the dietary mechanisms of autoimmunity in MS, which are almost the same for all autoimmune diseases--including RA. Those are: increased intestinal permeability, increased passage of luminal antigens into peripheral circulation, molecular mimicry and genetic susceptibility (genes encoding for the HLA system), among other factors.
In recent years, new substances have been discovered which might be responsible for increased intestinal permeability, namely saponins (found in legumes), potatoes, soya, quinoa, amaranth, alfalfa sprouts or tomatoes. If you've seen Dr. Cordain's scientific paper entitled "Modulation of immune function by dietary lectins in rheumatoid arthritis", I am sure you are aware of the role lectins play in autoimmunity.
Adjuvants are used by immunologists in order to boost the immune system and induce immunization. It turns out that certain foods have bioactive compounds that have adjuvant-like activity, this is the case for tomatoes or quillaja (a foaming agent used in beers and soft drinks).
Gliadin is a prolamine found in wheat which has been shown to increase intestinal permeability and hence the risk of suffering an autoimmune disease.
On the other hand, several clinical trials have been conducted with promising results. However, they have used a gluten-free diet or vegan diet instead of a whole paleolithic diet, which we think is the superior diet.
In vegan diets, authors often claim that the effects might be due to the lack of meat, but we think the positive effect relies on the lack of diary proteins and gluten. Meat has historically been seen as the "bad guy" in inflammation, but the data to support that notion is not sufficient to support this view.
Below are some references that could be useful.
Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: a randomized study. Elkan AC, Sjöberg B, Kolsrud B, Ringertz B, Hafström I, Frostegård J. Arthritis Res Ther. 2008;10(2):R34. Epub 2008 Mar 18.
A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Hafström I, Ringertz B, Spångberg A, von Zweigbergk L, Brannemark S, Nylander I, Rönnelid J, Laasonen L, Klareskog L. Rheumatology (Oxford). 2001 Oct;40(10):1175-9.
I hope this helps.
Maelán
